Individual
FAREESA SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2835 LAFAYETTE RD, INDIANAPOLIS, IN 46222-2147
(317) 924-1300
Mailing address
2835 LAFAYETTE RD, INDIANAPOLIS, IN 46222-2147
(179) 241-3003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004318A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2021
Last updated
07/01/2022
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